Provider Demographics
NPI:1477619450
Name:DAULAT, WENDY CARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:CARA
Last Name:DAULAT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:CARA
Other - Last Name:SCHOENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4149 SHARP RD
Mailing Address - Street 2:
Mailing Address - City:GLENELG
Mailing Address - State:MD
Mailing Address - Zip Code:21737-9526
Mailing Address - Country:US
Mailing Address - Phone:443-398-5911
Mailing Address - Fax:410-489-0814
Practice Address - Street 1:4149 SHARP RD
Practice Address - Street 2:
Practice Address - City:GLENELG
Practice Address - State:MD
Practice Address - Zip Code:21737-9526
Practice Address - Country:US
Practice Address - Phone:443-398-5911
Practice Address - Fax:410-489-0814
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry